Rituximab (ri TUK si mab)

Adult Medication

Brand Names: U.S.

Rituxan

Brand Names: Canada

Rituxan

Warning

Very bad and sometimes deadly side effects have rarely happened during and within 24 hours after the infusion. Tell your doctor if you have any bad effects during or within 24 hours after the infusion.

A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

If you have had hepatitis B before or carry the virus, this drug can cause the virus to become active. This can lead to very bad and sometimes deadly liver problems. You will be tested for hepatitis B before starting this drug, while on this drug, and for a few months after this drug is stopped. Do not take this drug if you have active hepatitis liver disease.

A very bad brain problem called progressive multifocal leukoencephalopathy (PML) may happen with this drug. It may cause disability or death. Tell your doctor right away if you have signs like confusion, memory problems, low mood (depression), change in the way you act, change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight.

What is this drug used for?

It is used to treat leukemia.

It is used to treat lymphoma.

It is used to treat rheumatoid arthritis.

It is used to treat Wegener’s granulomatosis.

It is used to treat microscopic polyangiitis.

It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

If you have an allergy to rituximab or any other part of this drug.

If you are allergic to mouse proteins, talk with the doctor.

If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

If you have an infection.

This is not a list of all drugs or health problems that interact with this drug.Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

Tell dentists, surgeons, and other doctors that you use this drug.

You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.

Have blood work checked as you have been told by the doctor. Talk with the doctor.

You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.

Very bad and sometimes deadly infections have happened in patients who take this drug. If you have any infection, are taking antibiotics now or in the recent past, or have had many infections, talk with your doctor.

Talk with your doctor before getting any vaccines. Use with this drug may either raise the chance of an infection or make the vaccine not work as well.

If you are taking this drug for rheumatoid arthritis, make sure you are up to date with all your vaccines.

If you are 65 or older, use this drug with care. You could have more side effects.

Use birth control that you can trust to prevent pregnancy while taking this drug and for up to 12 months after this drug.

Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.

Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Signs of infection. These include a fever of 100.4°F (38°C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain.

Very bad and sometimes deadly kidney problems have happened with this drug. Call your doctor right away if you are unable to pass urine or if you have blood in the urine or a change in the amount of urine passed.

Very bad and sometimes deadly bowel block or tears in the bowel have happened with this drug. Call your doctor right away if you have very bad belly pain; very hard stools (constipation); throwing up, throwing up blood, or throw up that looks like coffee grounds; or black, tarry, or bloody stools.

Patients with cancer who take this drug may be at greater risk of getting a bad and sometimes deadly health problem called tumor lysis syndrome (TLS). Call your doctor right away if you have a fast heartbeat or a heartbeat that does not feel normal; any passing out; trouble passing urine; muscle weakness or cramps; upset stomach, throwing up, loose stools or not able to eat; or feel sluggish.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

Feeling tired or weak.

Dizziness.

Headache.

Upset stomach or throwing up.

Belly pain.

Loose stools (diarrhea).

Runny nose.

Muscle spasm.

Muscle or joint pain.

Back pain.

Not able to sleep.

Night sweats.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read and follow the dosing on the label closely.

It is given as a shot into a vein over a period of time.

Acetaminophen and diphenhydramine may be given before this drug to lower fever and chills.

Methylprednisolone will be given before this drug in patients treated for rheumatoid arthritis.

What do I do if I miss a dose?

Call the doctor to find out what to do.

How do I store and/or throw out this drug?

This drug will be given to you in a hospital or doctor’s office. You will not store it at home.

Keep all drugs out of the reach of children and pets.

Check with your pharmacist about how to throw out unused drugs.

General drug facts

If your symptoms or health problems do not get better or if they become worse, call your doctor.

Do not share your drugs with others and do not take anyone else’s drugs.

Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.

Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.

Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.